HomeMy WebLinkAbout0009546 P
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I Lot No. .. I Block I Ward I Addition or Replal
OUTSIDE WORK
Dal.
Naw SEW" WATER STORMS' FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb j"c:... j.o-c!
FMm Curb 10 BuDding Electric Pumpa From Curb to Building
Repair
INSIDE WORK
lID.
NEW
us...
NEW
NO.
FEES
NEW
REP.
USED
REP. 1 USED
FEES
FEES
NO.
REP.
Bath Tub
Garbage DiJlpooah
Calch Bow
1-
Wuh Buin
DiJlhwuhers
Conductors
Watar Cl_t
Laundramau
Gre... Catch BoiDa
Sink
Water Sofiene..
Sump Pump lit Ejecto..
W8ier Heat...
Sanitary Bubble..
Bar and Soda Wast..
Showar B8ihR
Urinalo
Floor Dralaa
Laundry Tubs
Denial Cuspido"
Service Sinko
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Valuation of the Work Herein Described
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Fee Verified. Receipted and Recorded
Received Permit and Inopecllon Fees
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Date
In the performsnce of this work the undersigned owner (or his authorized agent) of said premises end his authorized Plumber hereby egree to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by Ihe Board of Public Works for the government of Plumbers.
It Is fu!!ler agreed by Ihe undersigned Ihat no other uses will be made of the above connections excepl as he.:pinaftar lisled.
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